17 de ago de 2011

Footbaths can harbor hazardous bacteria. The footbath in Tokyo pictured here is not known to be infected. (Asahi Shimbun file photo)

Footbaths, which have provided comfort to countless visitors to hot spring resorts, could be housing Legionella, a bacteria that can cause infectious diseases, including pneumonia, a researcher warned.

Katsunori Furuhata, associate professor of environmental microbiology at Azabu University, estimates that one in four footbaths in Japan contain Legionella bacteria.

"You are not likely to get sick just by putting your feet in one, but footbath operators should supervise sanitation responsibly," Furuhata said.

From 2009 to 2011, Furuhata studied samples from 125 footbaths at hot springs in 28 prefectures. He found Legionella bacteria in 31, or 25 percent, of them.

9 de ago de 2011

The patient was sent to Tuen Mun Hospital on July 31, two days after she experienced fever, cough and breathing difficulties.
Tests carried out determined she was suffering from Legionella Pneumophila.
The woman had remained at home. Her family didn't show the same symptoms.
The case, the ninth of Legionnaires' disease this year, is still under investigation, the Centre for Health Protection reported.
www.chinadaily.com.cn

7 de ago de 2011

Increasing rate of infection perplexes medical expertsHealth experts are baffled by New Zealand's accelerating rates of legionnaires' disease, with a Christchurch man the most recent victim.The 62-year-old man died in Christchurch Hospital on July 29 after being exposed to the legionella bacteria while gardening.A recently released report, prepared for the Health Ministry, showed a 141 per cent increase in cases, nationally, between 2009 and 2010.The pneumonia-like infection is usually caught by inhaling potting mix or exposure to contaminated water in plumbing systems, air-conditioning units or cooling towers.Of 178 cases last year, five people died and 136 required hospital treatment.In the first six months of this year, there had been 89 cases compared with 63 cases in the same period last year.University of Otago associate professor Michael Baker said he was surprised and "perplexed" by the report's findings.

6 de ago de 2011

Legionnaire's disease is spread by the inhalation of Legionella bacteria in water droplets and vapor. The bacteria is commonly found in the water supply, but may flare up under certain conditions leading to pose a risk of infection

Published: Saturday, August 06, 2011, 4:00 AM Cleveland.comParma — A routine water test in the intensive care unit at Parma Community General Hospital on Tuesday revealed elevated levels of Legionella, the bacterium that causes Legionnaire’s disease.As of Friday afternoon, no cases of Legionnaire’s had been reported.Hospital officials confirmed unusually high levels of the bacteria were found in faucet water from the ICU, although other areas of the hospital remained unaffected. Legionella is naturally occurring in water, but certain conditions, such as warm, stagnant water, can cause flare-ups.According to the Centers for Disease Control and Prevention’s website, hospital buildings are at particular risk because of their complex water systems and the fact that many patients have illnesses that increase their risk for infection.Legionnaire’s disease is contracted by inhaling contaminated water vapor. Common symptoms include a high fever, chills and a cough. Signs of illness usually begin two to 14 days after exposure.Infection can lead to a form of pneumonia and even death in 5 percent to 30 percent of cases, according to the CDC.Smokers, the elderly and people with lowered immune systems are more at risk of developing symptoms. Most patients can be treated successfully with antibiotics.Since the discovery of the high bacteria levels, the hospital has relocated two ICU patients who were considered vulnerable and released a third. Parma will continue selected admissions to the ICU, said hospital marketing director Mark White. Patients and staff have been alerted.White said that the hospital has already started eliminating the Legionella colonies by replacing the ICU faucets and flushing out the pipes with hot water.This is not the first time Legionella has been an issue at Parma General. Since a single case of Legionnaire’s disease occurred in 2002, the hospital has been voluntarily testing its water supply every quarter. White said there have been other instances of positive Legionella levels since testing began but no additional cases of Legionnaire’s.Cuyahoga County Board of Health Commissioner Terry Allan said that hospital officials had alerted his staff to the current situation. He applauded them for their continued testing regimen and reporting.

Last year, 33 cases of Legionnaire’s were reported in Cuyahoga County. There have been 22 cases so far this year.

3 de ago de 2011

A new water system is being installed at Sunderland's dry ski centre, after the legionella bacterium was found.

Silkworth Sports Complex was closed in June after higher than normal levels of bacteria were found during routine monitoring.

The bug can lead to Legionnaires' disease, a potentially fatal form of pneumonia.

Work on a new system to minimise the risk of future contamination is due to be completed by the end of August.

Julie Grey, head of community services at Sunderland City Council, said: "The investigation was undertaken as a precautionary measure, after regular tests showed higher than usual levels of contamination, including low levels of the legionella bacteria which is found naturally in all water courses.

"We appreciate our customers' patience while work continues and look forward to welcoming them to Silksworth ski-slope when it reopens."

Everything was running perfectly that spring afternoon at the courtyard-style Best Western Springdale in the suburbs of Cincinnati. Room service was humming along at a reliable clip. The floral-patterned comforters were getting fluffed. Kids were splashing in the pool. Then, suddenly, General Manager Jim Crane got an emergency call about a leak that was turning Room 529 into a virtual waterfall. Within minutes, he and the hotel's burly engineer were ripping apart the room's walls. Inside, they found something out of a B-grade horror movie: a deathly smelling mold so gooey and hairy it seemed like it was breathing.

Crane soon discovered that, like the Blob, the Aspergillus strain of mold was everywhere: swarming through bathrooms, sprouting out of ceilings, and creeping through the ventilation and vending machine areas. This was May, 1998, and for the next year Crane worked to rid the hotel of the mounds of black growth. He knew they were a disaster for guest relations, but what he didn't realize was that each time he took a breath, he was inhaling the mold's toxic fungal spores. These bioaerosols landed on the delicate mucous membranes of his airways and lungs, causing chronic inflammation and eventually leading to a medical diagnosis of hypersensitivity pneumonitis. The condition further scarred his lungs and eventually progressed into pulmonary fibrosis, a disease that is painful, debilitating, and sometimes even fatal. Slowly and invisibly, his workplace was killing him.

Today, Crane wheezes on his living room sofa--paying bills with his retirement savings and taking 17 different drugs each day. He filed a lawsuit in January against the hotel's owners, Laks Enterprises, which wouldn't comment on the suit. They lost the hotel through foreclosure to Bank of America in September after spending more than $2 million on an exhaustive remediation, and ''the hotel is now safe,'' says the hotel's director of sales, Karen Sullivan. Already, though, Crane has lost half of his lung capacity. Says Crane's physician, Dr. Eckardt Johanning, medical director of Eastern New York Occupational & Environmental Health Center in Albany: ''Lack of proper protection and maintenance in that building caused this tragedy.''

NO STANDARD. Crane's case may be an extreme example of what can happen when you work in a sick building, but he is hardly alone. Employees at Levi Strauss, US West, BP Amoco, even the Environmental Protection Agency, have claimed they suffered sick-building-related illnesses. Cases like these happen so often, in fact, that the World Health Organization estimates that one out of every three workers may be toiling away in a workplace that is making them sick.

The culprit: a stew of largely undetected dangers--from the carbon monoxide and other contaminants sucked into a building when air-intake vents overhang exhaust-filled loading docks and parking garages, to the volatile organic chemicals (VOCs) seeping out of building materials, furniture, office equipment, carpet, paint, and pesticides, to the molds and bacteria funneled through muck-filled heating, ventilation, and cooling systems (HVACs). Even the smoke from those puffing away at entrances gets sucked back into the building, chimney-style, because of the suction from revolving doors (what engineers call ''the stack effect'').

Putting in workaholic hours amid these contaminants is bad enough, but what makes it even worse is that, unlike at home, most of us can't even crack open a window at the office. Instead, we breathe yesterday's air and work in monotonous, uniform spaces under a forest of fluorescents, which can cause boredom, eyestrain, and lethargy. For those with robust immune systems, this may not matter much. But for 20% to 30% of the office population, the problems can range from the mild--headaches, nausea, dizziness, short-term memory loss, irritability, and itchy eyes and throats--to possible damage to the nervous and respiratory systems. Doctors also link the doubling of asthma rates since 1980 to bad indoor air.

Associated with sick-building syndrome is a controversial disease called multiple chemical sensitivity (MCS), which can make people allergic to almost anything containing a man-made chemical. This condition can sideline sufferers into surreal, boy-in-the-plastic-bubble worlds: Don Paladin, a former teacher, got MCS from pesticides sprayed at his school and is now forced to spend most of his time in his aluminum-sided ''sanctuary.'' Other MCS victims say they are forced to live outside or sport medical masks wherever they go. No wonder the EPA calls indoor air quality one of the top five environmental health risks of our time.

But even as the evidence mounts that sick-building illnesses are on the rise, the extent of the problem has been almost impossible to measure. Amazingly, the federal government has no effective standards for indoor air quality in offices. The Occupational Health & Safety Administration (OSHA) has standards that are supposed to protect workers against individual contaminants such as benzene and formaldehyde, both carcinogens. But those standards were set for industrial workplaces and have been force-fit to apply to white-collar offices. ''The OSHA standards don't always protect you from all kinds of exposures that people are having at the office,'' says Elissa Feldman, EPA's associate director of the Indoor Environments Div. ''There is no federally guaranteed protection from exposure to unhealthy air indoors.''

What's more, the chemical soup swirling through office air ''is a complex mixture that we just don't know that much about and no one has set standards for,'' adds Feldman. ''We're not [always] sure of the health effects.'' This, despite the fact that we spend 90% of our time inside--and more than half of that at work. What's also scary is that pollutant levels indoors are two to five times, and on occasion 100 times, more concentrated than outdoors, according to the EPA. ''There are offices in America that I've been in that were probably more dangerous to my health than a Superfund site,'' says William McDonough, former dean of the University of Virginia School of Architecture.

WORKER CLAIMS. Twenty years ago, sick-building complaints were often written off as the psychosomatic rantings of the disaffected--or just the whining of lazy boss-haters. Rare cases--like the shocking outbreak in 1976 of a mysterious lung ailment during an American Legion convention (now known as Legionnaires' Disease)--were considered medical aberrations that couldn't become commonplace. Today, those attitudes are fading in the face of new research buttressing the validity of sick-building syndrome, including new studies linking symptoms to buildings that are damp or freshly renovated.

Experts who study illnesses caused by buildings divide them into two categories. The first--building-related illness--is when readily identifiable microbes or fungi give people actual diseases, like the Legionnaire's outbreak in April from bacteria blown out of the Melbourne aquarium's air-conditioning system that killed four people and infected 99 others. The second--sick-building syndrome--is when people report symptoms that can't be traced to one cause. Local governments are now starting to legitimize these sick-building-related illnesses as a condition for social benefits. Nearly a dozen states from New Mexico to Maryland now recognize MCS as a bona fide claim for workers' compensation. MCS is also covered--on a case-by-case basis--under the Americans with Disabilities Act, obliging employers to make accommodations for sufferers.

U.S. companies could save as much as $58 billion annually by preventing sick-building illnesses and an additional $200 billion in worker performance improvements by creating offices with better indoor air, say researchers William J. Fisk and Arthur H. Rosenfeld of the Lawrence Berkeley National Laboratory in Berkeley, Calif. The researchers also found that the financial benefits of improving office climates can be 8 to 17 times larger than the costs of making those improvements. And the same VOCs that affect people can also harm expensive equipment. They create a film that covers computer circuit boards and telephone switches, causing them to blink or conk out, say Telcordia Technologies Inc. senior scientists Charles J. Weschler and Helen Shields. Just fixing those faulty phone wires has cost telecommunications companies more than $100 million over the past 10 years, they say.

Legal heat is also focusing attention on the issue. Last year, in a landmark case, the Ohio State Supreme Court awarded Joann Taylor an unprecedented $400,000 jury award from her former employer Centerior Energy Corp., now a part of First Energy. The charge: She was forced to keep working in her newly renovated office even after she had been rushed to the hospital with chest pains and vomiting from the chemical fumes in the new carpet. First Energy says no other employees had complaints and that Taylor had to keep working in that building in order to perform her job.

SKYLIGHTS. Indeed, sick-building cases are becoming more and more common--and are often filed against building owner/operators. While there were only a few such cases five years ago, today ''there are hundreds,'' says New York environmental consultant Wayne Tusa. It all adds up to indoor air becoming the next big environmental target, just as awareness of outdoor pollution led to the landmark Clean Air Act of 1970. Indeed, compared with European building standards, the U.S. seems stuck in the environmental Dark Ages (page 124).

But despite this growing climate of recognition, sick-building syndrome remains controversial. Many employers and building owner-operators say workers exaggerate illnesses. Doctors are often split on the issue, one camp dismissing many of the claims as hysterical, while the other sees them as the tip of the iceberg, foreshadowing a kind of chemical AIDS they say could be the scourge of the 21st century.

Even a company that does the right thing by being honest with employees about a building's dangers can be trapped in a legal quagmire. That's what happened to BP Amoco PLC after the company discovered a cancer cluster at its Naperville (Ill.) lab (page 128).

But a few businesses are taking action long before they get into trouble. At its Zeeland (Mich.) factory, furniture maker Herman Miller has created a virtual California. Workers sport Hawaiian shirts and blast the Beach Boys while working in an office that has 100% fresh air and daylight. After the factory opened, productivity improved by 1.5%, enough to pay off the building's $15 million mortgage. The place is so popular that 16 workers who quit last year for better-paying jobs all returned within two weeks because they said that they couldn't stand working in the dark. The U.S. Postal Service saw an even higher productivity gain--a stunning 16% jump--by simply installing skylights and improved lighting at its Reno (Nev.) postal sorting office. ''If any CEOs have half a brain, they would start to pay attention to the fact that their employees are their main cost-and-benefit center,'' says McDonough, now a consultant with Herman Miller and Steelcase. ''They can't afford not to do this.''

Blame the prevalence of sick buildings, in part, on the energy crisis of the 1970s. That's when office buildings began to be built as tight as tin cans, padded heavily with money-saving layers of insulation and equipped with hyperefficient HVACs. In many cases, these systems, run by operators looking to shave costs, suck in only five cubic feet of fresh air per minute per person. ''That is almost enough to keep people alive,'' quips New York architect Robert F. Fox Jr., whose firm designs environmentally friendly skyscrapers. Indeed, to save money, some operators shut down the fresh-air intakes altogether. The American Society of Heating, Refrigerating & Air Conditioning Engineers recommends that HVACs pump in 20 cubic feet of fresh air per minute per person--a level below which symptoms increase. But there is nothing compelling building operators to do so, says Mark J. Mendell, team leader for the indoor-air-quality research effort at the National Institute of Occupational Safety & Health (NIOSH).

Stagnant office air also circulates the residue of as many as 350 VOCs that are emitted by building materials, furnishings, and office machines. For example, most office paints contain solvents that can cause everything from eye, nose, and throat irritation to digestive and central nervous system damage. Carpeting sometimes contains PVCs that give off the carcinogen dioxin. Furniture is often made of particle board that is bonded with resins made with carcinogen-containing formaldehyde. That's not to mention the pesticides and cleaning products swabbed over offices that, according to the EPA, may also contain carcinogens that can be discharged into the office air.

No surprise, then, that sick-building-related symptoms are on the rise. Across the country, doctors who treat patients with sick-building-related illnesses say caseloads have mushroomed 40% in the past decade. ''There are more and more chemicals being introduced into the office environment through synthetic products, and ventilation systems have not caught up with being able to deliver fresh air,'' says sick-building specialist Dr. John B. Sullivan Jr. of the University of Arizona College of Medicine.

What makes it difficult for sufferers seeking remedies is that OSHA has no exposure limits for groups of chemicals that researchers believe might act synergistically. OSHA standards for acceptable amounts of benzene, for example, don't take into account the mixture of VOCs reacting with one another. This could be making building air even more dangerous, but because scientists don't yet know for certain how to measure for these combinations, the problems may be going undetected. That could also help explain, scientists say, why some buildings that are making people sick are getting clean bills of health. Or it may be that where standards do exist, OSHA's permissible exposure levels, which are often influenced heavily by politics and industry, are just too high. ''These exposure limits don't have any real bearing on what's happening in white-collar office buildings,'' says Alan Hedge, professor of human ecology at Cornell University. ''In terms of chemical irritation, we're seeing symptoms at levels way below OSHA's standards.''

''DEATH CUBE.'' An effort to enact sweeping indoor air standards stalled six years ago, when OSHA tried to issue a comprehensive smoking and indoor air-quality rule. The measure would have required all building operators to do basic, routine ventilation checks, change air filters regularly, and avoid using toxic cleaning substances. Not surprisingly, Big Tobacco went into overdrive behind the scenes to torpedo the move since the measure would have required all workplaces to be smoke-free. Shortly thereafter, in 1995, the 104th Congress was ushered in, and it fiercely opposed any new government regulations. The effort was squashed. ''Clearly, [sick-building syndrome] is a significant problem--though it is difficult to say how bad it is,'' says Charles N. Jeffress, Assistant Labor Secretary for Occupational Safety & Health. ''And it is very difficult to do something about it.'' That may be true at the federal level. But as states pass their own laws, Jeffress thinks it may be possible to learn which approaches work and which don't.

Until then, the stories are likely to mount, though they rarely make headlines. At Levi Strauss & Co., for example, internal memos obtained by Business Week show that for eight years, at least 60 employees complained about the air quality at the jeans maker's Stern office building in San Francisco. The workers were especially concerned about smoke from the wood-burning oven in the Il Fornaio restaurant on the ground floor. The mesquite-flavored fumes hung so heavy in the air that some employees rigged umbrellas over their desks to protect themselves from falling soot.

At least three people became disabled from acute asthma, severe allergies, and other environmental illnesses as a result of breathing in the carbon monoxide, the memos show. Things got so bad, employees say, that one office even got the grim nickname ''the death cube'' because three people who occupied it all died of cancer. Levi's took steps to revamp the building's ventilation system over the years, but the complaints persisted. ''It proved to be challenging to track the problem down and find the right steps to resolve it,'' says Linda Butler, Levi's senior manager for communications. Finally, the company raised the air intake vents in 1997 so that the fresh air wasn't commingled with the exhaust from the restaurant, and the problem was fixed, Butler says.

Sometimes, the trouble doesn't stem from an ongoing problem but from one simple renovation project. In 1991, at a former US West office in Walla Walla, Wash., some construction workers forgot to cover up the air-intake vents when they sprayed industrial-strength petroleum sealant on the building's facade as a part of a roofing and refurbishing project. Workers like clerk Juanita Johnson and telephone operator Rosie Gies, who had had a perfect attendance record during her first six years with the company, began suffering from nosebleeds and dizziness. ''I could barely breath at work because it hurt so much,'' says Gies, who eventually developed a case of reactive airway disease so debilitating that she says she couldn't lift her 3-year-old daughter. US West closed the office in late 1996 when it consolidated its directory centers. ''We did testing by independent consultants and found compounds well below OSHA's permissible exposure limits,'' says US West Communications Director Dana Smith.

Often, that's exactly what happens. Companies bat away complaints with test results showing that their workspaces meet OSHA standards. But when the standards clearly have been violated, lawsuits such as Celeste Morrell's can follow. Morrell was a case worker in the Social Services Dept. of New York's Onondaga County in 1988 when her department received a new shipment of wooden desks that had a foul, chemical odor. Turns out the double-pedestal desks, like much furniture, was made with particle board consisting of chips of wood glued together with formaldehyde. After breathing in the fumes all day, Morrell, a widowed mother of two, said she felt sick. When investigators scoured the office, they found formaldehyde levels in desk drawers that were up to five times OSHA's standard for short-term exposure. Morrell's physician diagnosed her with formaldehyde poisoning and ordered her not to work within 15 feet of the desks, but she soon developed multiple myeloma, a form of cancer her doctor linked to her office. Last September, just six months after her suit went to nonjury trial, Morrell died at the age of 51. A judge is still deliberating. ''Her desk killed her,'' says Morrell's attorney, Peter Littman of Ithaca, N.Y. Marc Violette, spokesman for the New York State Attorney General, says the state won't comment on the suit until after the judge has ruled.

HEAVY METAL. To make sure they never end up in court, some building owners, such as New York developer Durst Organization, are taking steps to erect greener and cleaner buildings on their own. Durst's newest building, the rocket-shaped Conde Nast tower, has solar panels, air intakes on every floor, and filters that screen out 85% of the city's contaminants (most buildings have filters that only keep out 35% of impurities). Some manufacturers, such as office furniture makers Steelcase and Herman Miller and office carpet maker Interface, are using materials in office furnishings that are less dangerous--a much needed move since many of the textile trimmings used in office fabrics, for example, are considered hazardous waste, a result of the heavy metal content of the dies and sealants used. Consider the office chair: ''Most people are sitting on chairs that are an amalgam of hundreds of chemicals that have never been defined in terms of their effects on human health, and the deeper we look, we find things that are cancer-causing chemicals,'' says the University of Virginia's McDonough.

Following the lead of these pioneers could well pay off for more companies. Time off from work due to illness can be cut by as much as 30% if workers simply have control over their office air, one study shows. Some states, such as New Jersey and California, are leading the way by enacting some indoor air standards. The EPA is also conducting its first-ever national assessment of the health of the country's office building stock, the biggest such study ever to be performed. Getting a better rating than the norm could be a marketing hook and might allow owners to charge even higher fees in today's helium-filled real estate market.

All this may signal the day when owner-operators make it a priority to choose building materials that are safer, companies demand air-quality reports before signing leases, and employees are as aware of their office's health as their own. Just like stock options and signing bonuses, workers are certain to start demanding fresh air and sunlight once they find out that other employees are getting them. Perhaps one day the office will even have its own annual checkup. If not, many American workers may not be around to complain. They'll be at home--sick.

Join an online discussion of sick buildings at www.businessweek.com/forums/

There have been a number of instances of Legionella bacteria in public spaces, which have led to people contracting the disease and even dying as a result. While it is common knowledge that a buildings cooling towers, air-conditioning, climate control systems and water storage areas are the main breeding grounds for Legionella the next greatest danger comes from spray mechanisms. Any device that has the potential to create a fine mist, aerosol effect or disperse droplets of water could possibly cause a problem.

Typical areas of concern in public spaces such as shopping centres, sports halls, exhibition spaces and stadiums or arenas are water features, fountains and waterfalls. These attractive decorations can act as easy disseminators for the Legionella bacteria. Health spas and leisure centres should also take care as whirlpool spas, Jacuzzi, swimming pools and hot tubs can all produce a fine spray or mist that will increase the risk of contamination.

The Legionella outbreaks during the 1999 Bovenkarspel Annual Flower Show in the Netherlands, where a whirlpool spa was to blame and the 2011 hot tub incident at the Playboy Mansion in Los Angeles both show how unmonitored public water features can help spread the infection.

Fountains, water sculptures and cascades form the central feature of many a town centre or shopping mall and these can be the perfect system from where to initiate an epidemic. Chlorination of public swimming pools, foot spas and Jacuzzis is a common treatment but unusual and novel water attractions need also to be monitored and maintained.

Maintenance staff, landlords and servicing companies should always carry out a Legionella Risk Assessment and check any water mechanism where there is a likelihood of producing small droplets, which could transfer the Legionella bacteria. Showerheads, artificial streams, indoor ponds and drinking stations should all be treated as potential danger points to pubic safety.

When considering the threat from Legionnaires disease most people are aware that cooling towers, water tanks and air-conditioning systems are a risk but how often are the fun, decorative and relaxing water features in our environment checked? These too are of importance when guarding against the threat of Legionella.

The Health & Safety Executive AcoP L8 (UK) guidance states that an employer or person in control of any premises has the responsibility to assess the seriousness of risk to staff and members of the public. Establish a course of action for preventing and controlling the risk and carry out regular maintenance, cleaning and disinfection of all water systems.Article Source: http://EzineArticles.com/6397075